腋下纵行小切口治疗胸部疾病171例

Vertical axillary mini-thoracotomy incision for 171 cases of thoracic diseases

目的 探讨腋下纵行小切口在胸外科的应用。方法 1994年至 1999年 171例经腋下纵行小切口手术的病人 ,其中自发性气胸、肺大泡 6 1例 ,动脉导管未闭 33例 ,结核球及肺良性肿瘤 2 7例 ,后纵隔神经源性肿瘤 2 0例 ,结核空洞 13例 ,支气管扩张症 7例 ,其他 10例。经腋下纵行小切口共行肺修补、肺大泡结扎术 5 9例 ,肺叶切除术2 3例 ,肺楔行切除术 2 1例 ,肺良性肿瘤摘除术 6例 ,动脉导管结扎术 33例 ,后纵隔肿瘤切除术 2 0例 ,其他 9例。结果 171例中 5例经腋下纵行小切口术中探查后扩大或改变切口。腋下纵行小切口平均开胸出血量为 96ml。 5 9例肺修补、肺大泡手术的术后平均引流量 176ml,平均住院时间 5天。 2例死亡。结论 腋下纵行小切口是治疗胸部疾病的一种可行的方法 。

Objective To review the experience of the vertical axillary mini-thoractomy incision for thoracic diseases. Methods 171 patients with 61 cases of lung bullae or spontaneous pneumothorax, 33 cases of patent arterial duct, 27 cases of tuberculoma and pulmonary benign tumors, 20 cases of posterior -mediastinal tumor, 13 cases of tuberculous cavity, 7 cases of bronchiectasis and 10 cases of other thoracic diseases. The operations of lung repair, ligation of bullae, pulmonary lobecotomy,wedge-shape excision of lung, ligation of patent arterial duct had been taken via the vertical axillary mini-thoracotomy incision.Results Five cases were enlarged or changed incision for better operation, the average volume of blood loss of the vertical axillary mini-thoracotomy incision was 96ml. The average drainage volume of the 59 cases that undertook the operation of lung repair or ligation of bullae was 176ml.The average hospitalization was 5 days.Two cases died postoperatively. Conclusion The vertical axillary mini-thoracotomy incision should be a reliable treatment to thoracic diseases, but the indications should be emphasized on.